The following is a summary of “Predicting outcomes in patients with exacerbation of COPD requiring mechanical ventilation,” published in the October 2024 issue of Critical Care by Alzaabi et al. 

Acute exacerbations of COPD (AECOPD) were commonly contributed to mortality, with the prognostic scores aiding clinicians in making personalized management decisions.  

Researchers conducted a retrospective study to assess the performance of the noninvasive ventilation outcomes (NIVO) score, designed to determine the in-ICU mortality and predict 1-year mortality and NIV failure in AECOPD.  

They analyzed data of individuals with AECOPD requiring mechanical ventilation from January 1st, 2018, to December 31st, 2022. Mortality was evaluated at both ends of the ICU stay and 1 year after admission, while NIV failure was defined as the need for intubation or death without intubation.  

The results showed that out of 302 ICU admissions for COPD, 190 individuals with AECOPD requiring mechanical ventilation were included. Among them, 44 (23%) passed away in the ICU, while 62 out of 184 (34%) patients experienced NIV failure. Additionally, 78 (41%) died within 1 year of admission. Those who died in the ICU or had NIV failure, had more severe COPD and more impaired blood gas levels at admission. The NIVO score had an AUC of 0.68 for predicting 1-year mortality and 0.85 for predicting NIV failure. A NIVO score greater than 7 was linked to higher 1-year mortality and NIV failure, with an HR of 4.4 [1.8–10.9] and 41.6 [5.6–307.9], respectively.  

They concluded the NIVO score was a reliable tool for predicting 1-year mortality and NIV failure in individuals with AECOPD, beyond predicting the in-ICU mortality. 

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01394-z